Provider Demographics
NPI:1417930298
Name:JOLKOVSKI, MICHAEL P (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:JOLKOVSKI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N WASHINGTON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3514
Mailing Address - Country:US
Mailing Address - Phone:703-533-8677
Mailing Address - Fax:
Practice Address - Street 1:500 N WASHINGTON ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3514
Practice Address - Country:US
Practice Address - Phone:703-533-8677
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001826103TC0700X, 103TC1900X, 103TP0814X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist